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John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I love that we are finally moving past the discussion of EMR implementation and moving towards EMR optimization. As David Chou, CIO at Children’s Mercy Kansas City, recently said in the CXO Scene podcast, “Hospitals have invested at minimum $100 million on their EHR and that doesn’t include all the consulting and training services required to implement the EHR on top of it.” Given this massive investment, it is more than time to optimize our EHR implementations and ensure we’re getting a great ROI from the investment.

In Galen’s EMR Optimization Whitepaper, they shared this really impressive matrix that looks at the clinical optimization effort required against the benefits an organization will receive from those efforts:

(Click on the above image to see the large version of the matrix)

There’s a lot to chew on in this matrix, so feel free to spend some time looking over the details. In fact, it would be beneficial to do a deep analysis of this matrix with your organization. No doubt you’ll uncover ways that your organization can benefit from better clinical optimization and it will help you evaluate areas where you should focus your initial attention.

While there’s a lot of detail in this matrix, I was struck by how few levers had an impact on costs. This is a tremendous insight to consider when it comes to EHR and clinical optimization and their impact on healthcare costs. No doubt there are other more important drivers of cost that need to be considered.

On the other hand, I was also struck by how many of the opportunities in the matrix were able to directly maximize revenue while also improving quality. Sometimes I think we look at the care we provide and see our efforts to improve quality as counter to our efforts to maximize revenue. This chart clearly illustrates how you can focus on improving the quality of care your patients receive while still maximizing your organization’s revenue.

I also like to look at the outliers in these matrices. In the matrix above, they’re found in the middle of the matrix. They require less effort, but the monetary ROI is high. I’m talking about “Keeping Patient in Network” and “Driving care delivery and managing acute and chronic diseases by evaluating the patient’s problem list in clinical documentation.” These are both things that can be done much more effectively on the back of the data found in the EHR. Are you maximizing these opportunities? I know many organizations that have barely begun the work of reducing volume leakage and improved clinical decision support. Those might be great places for your organization to start in your EMR optimization efforts.

What stands out to you when you look at the EMR optimization matrix above? Would you change any of the values in the matrix? Are there areas that are missing from the matrix that you would add? How many of these optimization efforts are you working on in your organization? We look forward to hearing your thoughts and perspectives in the comments and on social media.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of the universal truths about EHR software is that if you don’t get user buy-in, your EHR efforts will fail. You may even complete your EHR implementation, but not having user buy-in will wreak havoc on your ability to use the EHR to improve your organization. The failures may not be immediately apparent, but you can be sure your users will cause it to fail if they haven’t bought into the project.

On the other hand, organizations that do get end user buy-in to their EHR generally see great results.

One key to ensuring organizational buy-in is to set clear goals. Ideally these goals are created collaboratively with your team. However, it is most important that your EHR goals are attractive to your end users. If the end users are interested and excited about the goals you’ve set for the EHR project, then they’re more likely to support the project. Plus, setting these goals gives the project an important guide when you’re faced with tough decisions. Not to mention these goals serve as the perfect way to evaluate the success or failure of the EHR post-implementation.

Another way to ensure EHR buy-in from your end users is to invest in effectively training those users. There are a lot of skills a doctor needs to see patients effectively. Learning to use an EHR effectively is a learnable skill as well. However, you must invest in training that ensures end users have the skills they need to be effective EHR users. Effective training is a powerful way to improve EHR buy-in within your organization even if you have a less than perfect workflow.

Implementing an EHR often requires a change to your organization’s workflow. Many organizations postpone these workflow changes until after the initial implementation. They see this as a phased approach to the changes brought on by a new EHR. If you’ve done this, don’t forget to go back and reevaluate your current workflow against the new opportunities available in the EHR. You’ll often discover new workflows that will better serve your users and patients.

Finally, cultivating a group of peer champions for your EHR is a great way to get EHR buy-in. These peer champions can be there when challenging situations arise that need to be resolved. As advanced users, they can share solutions to problems with their peers in a powerful way that can’t be replicated by support desks.

The one theme across all of these ideas is having a great leader who understands their end users needs and then empowers them to be successful. Each of the above are just strategies a leader can employ to better understand, empower, and assist their end users to successfully use their EHR.

What other strategies do you use in your organization to gain EHR buy-in? What have been the consequences to organizations that haven’t spent the time and money to get buy-in? What could they and should they have done differently? Share your thoughts in the comments.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Healthcare and specifically healthcare IT seems to be full of distractions. There has always been a lot of regulations in healthcare, but lately, it seems overwhelming. We’re just coming out of one of the most overwhelming distractions to hit healthcare, meaningful use. However, just behind it is MACRA. If you’re part of any healthcare IT organization, you are certainly all too familiar with the impact these regulations have had on your organization.

While each of these regulations is important to your organization, it is worth taking the time to step back and evaluate what areas of your organization might be suffering because you were distracted by meaningful use and now MACRA. One area that’s suffered from these distractions is revenue cycle management. The harsh reality is that when we lose focus on revenue cycle management, it suffers.

Along with losing focus on revenue cycle management, other things are causing organizations’ revenue cycle efforts to underperform. One example of this is the impact switching to an all-in-one EHR system has had on revenue. Many organizations understand that there are benefits to a tightly integrated all-in-one system, but in many cases, these organizations have found that the revenue cycle management in these all-in-one systems is inferior to what they were using previously.

In some cases, the new system is the problem and is causing revenue shortfall. In other situations, when the organization switched to the new revenue cycle management system they didn’t train the users effectively on the new system. So much focus is paid on training the doctors and nurses, it’s easy to see how your revenue cycle professionals don’t get the training they need. Properly training these people on the new system can pay big dividends on the revenue side of things.

Related to training, many healthcare organizations are finding it a challenge to retain their high-quality revenue cycle staff. When a new staff joins the organization, they also will often suffer from poor quality training which directly impacts the bottom line as revenue cycle suffers. Creating a consistent and structured program for training new staff on your revenue cycle management software is a great investment for every organization. Plus, it will help retain those new employees who want to stay with an organization who cares about making sure they’re well trained to perform their job.

No doubt revenue cycle management is only one area that’s suffering amidst all of the regulations and distractions we experience in healthcare IT. Take the time now to sit down and understand what areas of your organization could benefit from some added attention, focus, and training. You’ll be surprised at the opportunities available to improve your organization similar to what’s described above for revenue cycle management.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As I look across the EHR market and think about the hundreds of healthcare organizations I’ve talked to, it’s become abundantly clear to me that the software you choose has very little to do with whether you’ll have a successful EHR implementation.

One way to illustrate this is to look at the EHR marketplace. Every single EHR out there has healthcare organizations successfully using their product. Sure, we could get into the nitty gritty of how hard it was to implement. We could dive into how one EHR may have an advantage in one area over another, but then the opposite is likely to occur in another area. The reality is that there are pros and cons to every EHR system out there. The real question isn’t can you successfully implement that EHR, but what are the problems you’re likely to have with the EHR you select.

Yes, all EHRs have problems.

I love the whitepaper that my sponsor, The Breakway Group put together on “Leadership Insights: Gaining Value from Technology Investments.” It’s worth reading the whole whitepaper, but one of the key insights from their research is that the biggest determining factor in a successful EHR implementation is leadership. Leadership matters more than anything else…even the software you choose.

I’m sure that many of you are looking at your EHR implementation and wondering if you agree with this insight or not. It’s easy to think about how the EHR selection process influences a successful implementation or not. If you get buy-in to the EHR selection process, then the EHR implementation goes much smoother. Others of you might be thinking about the process you used to implement the EHR and how that was extremely important to your successful (or not successful if you had a bad process) EHR implementation. I’m sure there are many more.

While these two items and many more influence a successful EHR implementation, what so many people miss is that each of these things mentioned is dramatically influenced by having an effective leader at the helm.

A great leader ensures that there’s buy-in by the staff during the EHR selection process. A great leader makes sure that the EHR is implemented in a way that is effective and takes into account the needs of the organization. We could go on and on. Great leadership will inspire everyone that’s involved in the EHR implementation. Nothing is more important.

Many of you reading this will probably look back and know all the issues you had in your EHR implementation that led to what you might considered a failed EHR implementation. You may even wish that you’d had the right leaders to avoid these problems. If that’s the case, the solution is still the same. A great leader can inspire an organization to overcome past failures and lead an organization down a path to make their EHR useful.

I think that organizations are finally realizing that EHR implementations aren’t a one time event. The EHR go-live is an important event, but it’s really just the start of the ongoing optimization that’s required to make the software as useful as possible for an organization. This takes thoughtful planning and you got it…inspired leadership.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Almost every healthcare organization I meet is talking about how to get better adoption of their EHR software. They’ve implemented their EHR as part of a massive go live. Many are even doing fine with programs like meaningful use and are working on MACRA. However, they all realize that adoption of their EHR software by end users could be better than it is today.

During these conversations, it’s easy to see how some organizations slip into the thinking that if they replaced their EHR with a new one that somehow that would spur more adoption and EHR use by their end users. When you hear users complaining about EHR software, it’s easy to blame the software itself. This is a dangerous line of thinking because that’s just not how it works. Switching EHR software does little to improve adoption of EHR by end users. EHR adoption problems that exist with one EHR are likely to exist in any new EHR.

That’s not to say there aren’t legitimate reasons for you to switch EHR. There are many good reasons to switch EHR software including when your organization is bought out and you want to align EHR software or when your product is being sunset. These can be good reasons to switch EHR and there are many more. However, it’s usually a mistake to switch EHR when you don’t have a good strategic reason to switch and lack of adoption is not a good strategic reason to switch.

When EHR adoption is lacking in your organization, instead of considering switching EHR, look at doubling down on your existing EHR. Core to successfully “doubling down” is leadership. Heather Haugen highlights this fundamental principle in her whitepaper “Leadership Insights: Gaining Value from Technology Investments when she says, “Organizations with leaders who are fully invested in the daily march toward adoption will reach the early stages of adoption quicker and enjoy a reinforced cycle of meaningful clinical and financial outcomes.”

The most successful organizations I’ve seen are led by people who understand that EHR adoption is not a one time event, but is an ongoing process of workflow improvement, training, and process modification. The value an EHR can provide is extracted as organizations incrementally improve their use of the EHR. It doesn’t happen by accident or by happenstance. It requires thoughtful and well executed leadership.

The idea of replacing your EHR to improve EHR adoption and use is often just an easy way out from addressing the real reasons why EHR use in your organization is not optimal. When this happens, you’re still generally faced with the same hard challenges after replacing your EHR. Don’t fall into this trap in your organization. If there’s not a strategic reason to replace your EHR software, then don’t. Take the energy you’d have spent replacing your EHR and make a deeper investment in optimizing your current EHR usage. That investment will pay off far more than an EHR switch.

The following is a guest blog post by Mark Muddiman, Engagement Manager at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Imagine you have just installed your new clinical information system. Everyone has been waiting for months and excitement has peeked; the big day is right around the corner. Go live is coming and all the organizational sites are prepared for the new workflows and application. The application goes live and suddenly everyone needs help, support is inundated, and it becomes apparent that the expectations were not aligned to the reality of preparedness.

All too often this is a common scenario for organizations that are dispersed over large geographic areas. Adopting healthcare technology is difficult in a singular location, but certain challenges are uniquely amplified when an organization is dispersed. What challenges can you expect related to adoption and learning, and what can you do to ensure you are prepared?

Expect a greater emphasis on change management
As HIMSS reports, individual sites may fight the loss of autonomy as everyone is brought to a standard application or workflow. Each location has developed their own way of using the legacy application, and they must now learn new procedures and processes in addition to a new application. Multiple locations present multiple groups to manage at a distance, without the ability of physical project team members to be present at all locations throughout the adoption process.

Expect deviations from best practice and follow-up learningMedical Economics recommends that learning continues beyond the initial go live. Staff will deviate from the best practice workflows as they forget less common tasks, and learn to navigate and use the application in different ways. Deviation from workflows introduces inefficiencies, dependency for support, and impedes the ability of staff to rotate between locations because the experience differs. Anticipate a need to provide follow up learning that reinforces best practices and helps avoid poor use of the application.

Expect each location will need onsite support
During go live, staff will often forget where to start and need a source to turn to when they forget a step in the new application and workflow they are using. However, it is very expensive and likely impractical to have a project team available at each location. Instead, providing assistance through super users and clinical champions along with easily referenced education materials will provide accessible onsite support for most issues.

What can you do?

Bring local leadership into decision making
Regional and local leaders can clarify the unique needs and constraints of their site when selecting applications and designing workflows. Whether equipment varies at each site or there are different service offerings, there are multiple benefits of involving local leadership. It allows leadership to determine the appropriate level of standardization that still respects the unique needs of each site, consequently removing the necessity to deviate from the standard workflow. Involving local and regional leaders engages them, provides a sense of ownership and cooperation in the project, and will help reduce resistance to change. It is imperative leadership is aligned at all levels, engaged in the adoption process, and supportive of the approach if adoption is to succeed.

Implement and ensure metrics are utilized
Metrics serve as key indicators to progress, knowledge retention, and proficiency, but in dispersed locations metrics also serve as indicators that would otherwise be filled with in-person observation. Metrics show whether a location is developing poor workflow practices or struggling with the change; subsequently metrics indicate whether a site needs additional support or learning. New metrics may be employed, such as surveys to gain feedback from multiple sites that could otherwise be obtained from a meeting or observation.

Follow up with each location often
Some sites will likely be more vocal in their need of support than others. It’s important to follow up with all sites and provide remedial education if metrics indicate a need to do so. Staff may need refresher training if inefficiencies arise, but there may be a root cause such as an educational or workflow gap that was previously unknown. Because adoption is a long-term commitment, it is important to provide continuous availability of learning while sustaining content to support changes to the application and learning needs.

Employ communication from leadership effectively
Effective communication goes a long way in reducing resistance to change. It also provides a channel for feedback and continuous collaboration. Communication should come from executive leaders to show their support of the adoption initiative, but also from local leaders. Staff can’t stop operations in a healthcare setting to join conference calls, and emails aren’t always read, but local leaders are able to directly communicate with staff. A comprehensive set of communications ensures an aligned message at all leadership levels and improves the ability of messages to reach staff.

While these suggestions may help, there is a proven methodology to comprehensively address challenges. At the Breakaway Group, we work with leadership to support engagement and change management at all levels while providing comprehensive sets of communication. Our experienced teams can provide workflow recommendations and develop education directly from the application that is sustained through the life of the partnership. Real-time data and metrics provide indicators of how each location is performing and undergoing change. Regardless of the organizational structure or of what to expect, we employ a methodology to help any organization achieve successful technology adoption and value realization.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

At this point, the great majority of providers have made very substantial investments in EMRs and ancillary systems. Now, many are struggling to squeeze the most value out of those investments, and they’re not sure how to attack the problem.

However, according to at least one piece of research, there’s a couple of approaches that are likely to pan out. According to a new survey by the American Society for Quality, most healthcare quality experts believe that improving clinical workflow and supporting patients online can make a big diference.

As ASQ noted, providers are spending massive amounts of case on IT, with the North American healthcare IT market forecast to hit $31.3 by 2017, up from $21.9 billion in 2012. But healthcare organizations are struggling to realize a return on their spending. The study data, however, suggests that providers may be able to make progress by looking at internal issues.

Researchers who conducted the survey, an online poll of about 170 ASQ members, said that 78% of respondents said improving workflow efficiency is the top way for healthcare organizations to improve the quality of their technology implementations. Meanwhile, 71% said that providers can strengthen their health IT use by nurturing strong leaders who champion new HIT initiatives.

Meanwhile, survey participants listed a handful of evolving health IT options which could have the most impact on patient experience and care coordination, including:

Putting online tools in place that touch every step of patient processes like registration and payment (69%)

Despite their promise, there are a number of hurdles healthcare organizations must get over to implement new processes (such as better workflows) or new technologies. According to ASQ, these include:

Physician and staff resistance to change due to concerns about the impact on time and workflow, or unwillingness to learn new skills (70%)

High cost of rolling out IT infrastructure and services, and unproven ROI (64%)

Concerns that integrating complex new devices could lead to poor interfaces between multiple technologies, or that haphazard rollouts of new devices could cause patient errors (61%)

But if providers can get past these issues, there are several types of health IT that can boost ROI or cut cost, the ASQ respondents said. According to these participants, the following HIT tools can have the biggest impact:

Remote patient monitoring can cut down on the need for office visits, while improving patient outcomes (69%)

Patient engagement platforms that encourage patients to get more involved in the long-term management of their own health conditions (68%)

EMRs/EHRs that eliminate the need to perform some time-consuming tasks (68%)

Perhaps the most interesting part of the survey report outlined specific strategies to strengthen health IT use recommended by respondents, such as:

Embedding a quality expert in every department to learn use needs before deciding what IT tools to implement. This gives users a sense of investment in any changes made.

Improving available software with easier navigation, better organization of medical record types, more use of FTP servers for convenience, the ability to upload records to requesting facilities and a universal notification system offering updates on medical record status

Creating healthcare apps for professional use, such as medication calculators, med reconciliation tools and easy-to-use mobile apps which offer access to clinical pathways

Of course, most readers of this blog already know about these options, and if they’re not currently taking this advice they’re probably thinking about it. Heck, some of this should already be old hat – FTP servers? But it’s still good to be reminded that progress in boosting the value of health IT investments may be with reach. (To get some here-and-now advice on redesigning EMR workflow, check out this excellent piece by Chuck Webster – he gets it!)

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

The following is a guest blog post by Shawn Mazur, Instructional Writer at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
There seems to be a trend in the education processes of a go-live for large EHR implementations: they’re scary. For large hospitals, the task of providing learning to hundreds, if not thousands, of employees for a go-live is daunting, and no matter how much time and resources you pour into designing the perfect curriculum and planning out a detailed schedule, you may quickly end up feeling like your learning effort is falling short. Learning metrics can play a vital role in making the task of creating and managing learning for a big go-live a little less scary.

Despite high levels of EHR implementations since the HITECH Act, many organizations still have significant go-live events in their future. A majority of learners are at least somewhat familiar with EHR systems, so education needs to be focused on making learners comfortable with a new, or advanced, EHR rather than teaching all there is to know about the systems. Since 2014, the number of buyers replacing existing EHR software has increased 59%, according to a 2015 EHR BuyerView report. It was also reported that challenges facing an organization were not overcome by the implementation of a new EHR. A lack of education for any go-live event will discount the value behind a new EHR.

Having the perfect plan for EHR education from the beginning is not the only key to successfully preparing your employees for go-live. Additionally, you should implement a plan to monitor the training process, completing learning metrics as you go, and then be flexible in how you carry out the remainder of your learning. So, you decide to be flexible in the information you provide to learners, but when do you know it’s time for a change in direction? Going beyond the summary of what your users should learn if they complete all of their learning, the following four metrics tell you how learners are reacting to the content.

1. Completion Summary
A simple but effective metric that lets you know how much progress your users have made in their learning objectives. This metric is especially important with e-learning and with self-paced learning. Collecting this data will also help you identify problems with different learning roles throughout your organization. Flagler Hospital, a regional hospital, kept completion summary metrics throughout their large switch from Meditech to Allscripts. They reported that their completion metrics began to show users were completing their learning much faster than expected. This data allowed Flagler to actualize their education plan to make remarkable reductions in training schedule, time, and cost from their original plan. Had Flagler’s completion summary shown less than satisfactory numbers, it would have also provided an opportunity for changes to be made. Low completion rates may mean that one role’s users are getting stuck at a certain point of their learning or struggling to even begin. In these cases, use completion metrics to push learning requirements along in time for go-live.

2. Assessment Summary
If your organization isn’t planning on testing users on the education they’ve received, it may be time to consider doing so. Using a step-by-step simulated assessment is the easiest way to put a solid number on how prepared your users are for navigating workflows in the live system. After implementing tests, compile metrics on them at a high level, including how many learners took their test, how many times each user attempted a test, and of course, the percentage of assigned learners who successfully passed their test. Flagler hospital also used assessment metrics alongside their completion summary. As a result, they saw that that their completion summary aligned with their assessment summary. Along with the fast pace at which they were completing learning, Flagler’s learners had average testing scores of 94 percent. The high test scores solidified their decision to make changes to the original learning schedule.

3. Assessment Audits
After implementing step-by-step testing of your user’s knowledge, dig deeper into your testing scores to pinpoint exactly where users are falling short. You will often find that a deficiency in learning curriculum leads to users missing the same steps during their test. For example, let’s say you break down your scores by step and see that over 60 percent of users clicked the incorrect button for documenting current vitals. This is an advantage over less effective traditional testing methods, like multiple choice formats. From this metric, it is clear that you should delegate additional learning resources on best practices for entering vitals before your go-live approaches.

When you test users without using the metrics to facilitate better learning, your learners will feel frustrated with their lack of proficiency. In his book, Why High Tech Products Drive us Crazy, Alan Cooper defines two types of learners. He says, “Learners either feel frustrated and stupid for failing, or giddy with power at overcoming the extreme difficulty. These powerful emotions force people into being either an ‘apologist’ or a ‘survivor.’ They either adopt cognitive friction as a lifestyle, or they go underground and accept it as a necessary evil.” Auditing your tests by step gives you the opportunity to return to your curriculum to elaborate on topics with low testing proficiency. Pinning down topics that require additional learning will eliminate the frustration and feeling of defeat among learners failing their assessments.

4. Knowledge and Confidence Level
Confident learners are a good thing, but not always the best come go-live. It is important that your learners not only have confidence, but also the knowledge to back it up. When knowledge and confidence are not aligned, the user is in a bad place for not only lacking proficiency in the system, but for their education going forward. Users who are pushed to use the live system before they feel confident enough will be far from proficient in the system, and will feel a resentment against the organization moving forward. Equally so, users confident to get in the system but lacking the knowledge to be proficient will also fail, and be quick to blame it on poor learning. In his book, Cooper also says, “Users only care about achieving their goals.” When learners can’t achieve their goals for the learning, they are quick to find a way to reach their goal, defining their own workflows and workarounds instead of sticking to best practices outlined by your organization. Collecting data from your learners, usually through a survey-like format, on how confident they are to start working in the live system and how knowledgeable they feel about the information taught, will help you gauge how ready users are for go-live. When aligning this with your other learning metrics, you will quickly see how ready your users are to proficiently use the live system.

It is often the case that the education plans you spent countless amounts of time and resources on leaves learners feeling distant with the EHR. Think about how you can use metrics to track your learning and be flexible to make changes using those metrics to benefit your learners in the long run.

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.

The following is a guest blog post by Lauren Brown, Adoption Specialist at The Breakaway Group (A Xerox Company). Check out all of the blog posts in the Breakaway Thinking series.
Gaining clinical, financial, and operational value from Electronic Health Record (EHR) applications has become a top priority for most health organizations across the country. Gone are the days of simply focusing on implementation that, in many cases, led to dissatisfaction and low adoption rates by staff. Previously, dissatisfied customers began looking to switch applications in hopes of gaining better results. However, studies show that switching EHRs does not solve the dissatisfaction problem. In fact, only a reported 43% of physicians are glad they made the switch to a new application, and 49% reported lower productivity as a result of the switch.

Recently, there has been a shift towards optimizing these new technologies and focusing on how to get the most out of their chosen application. It is essential for organizations to establish an optimization plan in order to achieve long-term, measurable results. Utilizing a metric-driven optimization approach gives healthcare organizations the opportunity to maximize their EHR investment and uncover opportunities for adjustments that substantially bolster technology integration.

Metric-driven optimization analyzes performance data and uses this information to drive continuous performance improvement throughout the organization. The U.S. Department of Health and Human Services suggests focusing metrics on how the system performs, how it will affect the organization, and how users experience the system. The ultimate goal is to execute well-designed strategies to help organizations identify and reduce workflow inconsistency, maximize application performance, and improve patient care.

So what are the keys to a metric-driven optimization approach?

Incorporate metrics early

Initial training serves well in focusing on application basics. But adoption occurs at a varying pace, so it’s important to continually monitor training and create a plan for late adopters. During training, staff will likely remember only a small portion of the information they are taught; if optimization occurs too late in the process, users do not learn best-practice workflow. This can result in workaround habits that become difficult to change. The use of metrics early in the process will help to monitor EHR adoption and focus on areas of opportunity. Metrics allow you to identify individuals who are struggling with their education and intervene.

Utilize system data found through metrics

Often, healthcare organizations try to mimic processes and workflows from past applications or paper records. This method can get you through the initial implementation, but it is not sustainable for long-term adoption. Before implementation begins, it’s important to analyze and document best practice procedures. In order to get the most out of the system once it’s in place, you’ll want to examine staff performance and analyze key workflows. The insights you gain will help ensure that productivity and stability continue to increase over time.

Capturing the right data allows you to identify inconsistencies and application issues that would have otherwise gone unnoticed. Developing and reporting metrics shows the value of optimization efforts and helps support staff moving forward. Existing workflow issues, if not addressed, will become more visible with technology. Utilize the technology to eliminate redundant, time-consuming processes. Look at your EHR as the leverage you need to create change to promote consistency and transformation across the organization.

Metric-driven optimization is an ongoing process

The need for optimization is an ongoing effort – not a one-time event. Incorporating metrics into the long-term roadmap as a continuous project will allow you to respond to changes in a timely fashion. Comprehensive metrics regarding how end users will be able to reach proficiency in the EHR application is an important element in ensuring adoption success. The more metrics are shared the more value an organization can gain from optimization efforts. Changes, including system upgrades and new employees, can continue to challenge optimization efforts that were previously made. They often require both functional and cultural changes in processes that impact many different groups across an organization. Data regarding these changes are key to ensuring those who will be impacted are aware and have the ability to adopt for the life of the application.

By taking a metric-driven optimization approach, healthcare organizations improve their use of technology and achieve long-term adoption. Instead of simply installing an EHR, the application is leveraged to enhance performance and push organizations to exceed expectations with patient care.

How has the use of metrics improved your organization’s technology adoption?

Xerox is a sponsor of the Breakaway Thinking series of blog posts. The Breakaway Group is a leader in EHR and Health IT training.

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

These 3 tweets definitely illustrate a theme from these hospital CIOs. We focus too much on the EHR implementation as a one time event and not the ongoing EHR optimization which is 80% of the project (as one CIO defined it).

Understatement of the day: we have a lot more work to do to get to value based care. #hctassembly

I think all of us can’t wait for this day. I’m not that optimistic that we’ll just wake up to a change. If we do wake up to a change like this I have a feeling it will sneak up on the current healthcare establishment from outside healthcare as we know it today.

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